ZZVA-*COLORECTAL CANCER SCREEN (FOBT) (6)    REMINDER DEFINITION (811.9)

Fecal occult blood test due every year for patients ages 50 and older, or
    Target Condition: Early detection of colon cancer or its predecessors.
 
    Target Group: All persons ages 50 and older.
 
    Recommendation: All persons age 50 and older should receive an annual
    fecal occult blood test or undergo a sigmoidoscopy examination
    (periodicity unspecified).
 
    Goals for FY 2000: For persons age 50 and older: 50 percent of those
    enrolled in primary care clinics have received fecal occult blood
5 years after the last Sigmoidoscopy.  The 5 years is a conservative
    testing within the preceding year and 40 percent have received at
    least one proctosigmoidoscopy examination in their lifetime.
period recommended by a blue ribbon panel publishing their findings in the
February 1997 issue of "Gastroenterology" magazine. 
  
This VA-*COLORECTAL CANCER SCREEN - FOBT reminder is based on the
"Colorectal Cancer Detection" guidelines specified in the VHA HANDBOOK
1101.8, APPENDIX A.
 

• FINDING ITEM:   FOBT(CLINIC)
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0
  USE IN RESOLUTION LOGIC:   OR
• FINDING ITEM:   ZZVA-FOBT
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0
  USE IN RESOLUTION LOGIC:   OR
• FINDING ITEM:   ZZVA-FLEXISIGMOIDOSCOPY
  MINIMUM AGE:   50
  NO. OF FOUND TEXT LINES:   1
  NO. NOT FOUND TEXT LINES:   0
  REMINDER FREQUENCY:   5Y
  FOUND TEXT:   

  FOBT due 5 years after the last sigmoidoscopy.
  

  RANK FREQUENCY:   2
  USE IN RESOLUTION LOGIC:   OR
• FINDING ITEM:   ZZVA-COLORECTAL CANCER SCREEN
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0
• FINDING ITEM:   INACTIVATE FOBT CANCER SCREEN
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0
  USE IN PATIENT COHORT LOGIC:   AND NOT
• FINDING ITEM:   ACTIVATE FOBT CANCER SCREEN
  MINIMUM AGE:   50
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0
  REMINDER FREQUENCY:   1Y
  RANK FREQUENCY:   1

This reminder is based on Taxonomy Findings from FOBT, "or" SIG cancer
to due every 5 years for patients 50 and older (note the rank of 2). After
a SIG has been received by the patient, if the clinician determines the
FOBT should be given to this patient again annually, the FOBT can be
activated again by entering the Health Factor "ACTIVATE FOBT CANCER
SCREEN" for the patient (Note the rank of 1).
 
Check the Taxonomy Findings entries representing Fecal Occult Blood Test
and VA-FLEXISIGMOIDOSCOPY. The taxonomies represent coded standard entries
in the CPT file and ICD Operation/Procedure file.  If one of these
taxonomies need modification, copy the taxonomy to a new taxonomy for your
screening, "and" FOBT exam results recorded from a clinic encounter as
site, and make the appropriate modifications. THAN, copy the reminder to a
new reminder to add your local sites modifications.
 
This reminder cannot make use of the Laboratory package data at this time
because the Occult Blood results are Microbiology tests that do not
reflect the Laboratory Test done, or the related CPT code.
an EXAM. See the definition for VA-*COLORECTAL CANCER SCREEN (SIG.)
also. These two reminders work together for assessing cancer screening. 
 
The FOBT is due annually, unless a SIG is found. The SIG found changes the
frequency to due once in a lifetime (99Y) according to the M-2 document,
but a more conservative approach is encouraged by the National Center for
Health Promotion to use 5 years (5Y).  The SIG found changes the frequency

• REMINDER FREQUENCY:   1Y
  MINIMUM AGE:   50
  NO. OF AGE MATCH LINES:   0
  NO. OF AGE NO MATCH LINES:   0